(ACO) regulations - American Society of Anesthesiologists

CMS-1345-P 323
harm to beneficiaries or impact on care, we propose to allow ACOs the opportunity to
submit a corrective action plan (CAP) before termination. We further propose that the
ACO must submit a CAP for our approval by the deadline indicated on the notice of
violation. The CAP must address what actions the ACO will take to ensure that the
ACO, ACO participants, ACO providers/suppliers, and entities performing services or
functions on behalf of the ACO will correct any deficiencies to remain in compliance
with Shared Savings Program requirements. The CAP must be implemented as
approved. The ACO's performance will be monitored during the CAP process. Failure
of the ACO to submit, obtain approval for, or implement a CAP may result in termination
of the agreement. Failure of the ACO to demonstrate improved performance upon
completion of the CAP may result in termination. We seek comments on our proposal,
including any additional conditions that could merit the termination of an ACO
agreement.
4. Reconsideration Review Process
Section 1899(g) of the Act, as added by section 3022 of the Affordable Care Act,
states that there shall be no administrative or judicial review of the following actions:
● Specification of criteria for meeting quality performance standards under
section 1899(a)(1)(B) of the Act.
● Assessment of quality of care furnished by an ACO and the establishment of
quality performance standards under section 1899(b)(3) of the Act.
● Assignment of Medicare FFS beneficiaries to an ACO under section 1899(c) of
the Act.